SIUE Counseling Services Survey

Thank you for taking time to complete this survey. We are interested in your perceptions of your experience with Counseling Services (CS) thus far. Your participation in this survey will help us continue to improve our services. Your responses are anonymous unless you choose otherwise. When you are finished, please return the survey to the front desk.

Counselor’s Name ______

Your Gender: ______Your Age: ______Number of sessions attended to date: ______

Type(s) of counseling currently attending: ____Individual _____Couples _____Group

For items 1-20, please place a check in the box under the statement that best indicates your level of agreement.

Reception and Appointments / Strongly
Agree / Agree / Somewhat
Agree / Neither
Agree nor
Disagree / Somewhat
Disagree / Disagree / Strongly
Disagree / N/A
1.  I am able to schedule appointments without difficulty
2.  The CS staff assisting with scheduling are helpful and courteous
3.  The waiting room atmosphere and accommodations are comfortable
4.  The number of counseling sessions available to me is sufficient
5.  Sessions generally begin on time
6.  The response of staff to crisis needs is prompt (may/may not apply)
7.  The length of time until initial appt. after contacting CS is reasonable
Counseling Relationship / Strongly
Agree / Agree / Somewhat
Agree / Neither
Agree nor
Disagree / Somewhat
Disagree / Disagree / Strongly
Disagree / N/A
8.  My counselor is helpful
9.  My counselor seems competent
10.  My counselor understands my concerns
11.  My counselor helps me take responsibility for my behavior and feelings
12.  My counselor creates a safe atmosphere in which I can explore my concerns

(Please turn over)

Counseling Goals and Outcomes / Strongly
Agree / Agree / Somewhat
Agree / Neither
Agree nor
Disagree / Somewhat
Disagree / Disagree / Strongly
Disagree / N/A
13.  My counselor helped me set appropriate goals for counseling
14.  Counseling is helping me to be more effective in my academic performance (may/may not apply)
15.  Counseling is helping me to cope better with my emotions
16.  Counseling is helping me to be more successful in my interpersonal interactions
17.  I feel I am benefiting from engaging in counseling
18.  Overall, I am satisfied with the experience of counseling at CS
19.  If I needed help in the future, I would return to CS
20.  I would recommend CS to a friend who needed help

Other comments or suggestions about your counselor or the service: